婴儿和学前幼儿诊断性评估中文版注意缺陷多动障碍模块的效度和信度

目的:引进婴儿和学前幼儿诊断性评估(DIPA),评价其中注意缺陷多动障碍(ADHD)诊断模块的效度和信度。方法:经原作者同意后,将DIPA翻译为中文版。根据以注意力不集中或多动为主诉的244例疑似ADHD学龄前儿童及医院周边社区幼儿园招募的90例正常学龄前儿童,以精神科临床医生根据精神障碍诊断与统计手册的ADHD诊断标准进行的临床诊断为金标准,评价DIPA诊断学龄前ADHD的效度。4名评定者分别独立对被试进行DIPA诊断,考察评定者间一致性。其中39例被试在DIPA访谈后14d,再次接受DIPA访谈,考察重测信度。结果:以临床诊断为金标准,对DIPA进行效度检验显示,诊断一致性的kappa值为0.81,诊断学龄前注意缺陷多动障碍的灵敏度为89%,特异度为96%。DI-PA的评定者间一致性kappa值为0.79,重测信度为0.89。结论:婴儿和学前幼儿诊断性评估中文版的ADHD诊断模块具有较高的效度和信度,可用于临床学龄前ADHD的诊断。

Validity and reliability of the Chinese version of the Diagnostic Infant and Preschool Assessment in diagnosing ADHD

Objective:To evaluate the validity and reliability of the Diagnostic Infant and Preschool Assessment(DIPA) for diagnosing ADHD in preschoolers in China.Methods:DIPA was translated into Chinese and administered to 244 suspected ADHD preschoolers with attention deficit or hyperactivity related symptoms and 90 kindergarten students recruited from nearby community kindergarten.The clinical diagnose by senior chief psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders was the gold stand ard as to explore the validity of DIPA.Four interviewers were included in the inter-rater reliability training.Fourteen days after the first DIPA interview, 39 participants were evaluated by the second DIPA interview to assess the test-retest reliability.Results:Using clinical diagnose as the gold standard, the validity test showed that the sensitivity was 89% for pre-schooling ADHD,and the specificity was 96%.The inter-rater reliability was 0.79 and the test-retest reliability was 0.89.Using clinical diagnose as the gold standard, the diagnostic consistency was 0.81.Conclusion:The Chinese version of DIPA has good validity and reliability in diagnosing preschool ADHD.